Therapeutic Potential of Omega-3 Fatty Acids in Periodontal Disease - A Narrative Review

Aim: This narrative review critically examines the clinical and mechanistic evidence regarding the use of omega-3 polyunsaturated fatty acids (PUFAs) as adjuncts in periodontal therapy. The objective is to assess the consistency of reported outcomes, evaluate the quality of available randomized controlled trials (RCTs), and identify methodological limitations that hinder firm clinical recommendations. Methods: A structured literature search was conducted in PubMed, Scopus, and Embase for peer-reviewed studies published between January 2010 and April 2025. Search terms included “omega-3 fatty acids”, “PUFA”, “EPA”, “DHA”, “periodontitis”, “host modulation”, and related terms. Inclusion criteria comprised clinical trials, systematic reviews, and relevant experimental studies with full-text availability. No meta-analysis was performed due to heterogeneity in study design and outcomes. Results: Omega-3 fatty acids, particularly EPA and DHA, may contribute to periodontal therapy by modulating inflammation, enhancing the production of specialized pro-resolving mediators (SPMs), and reducing levels of pro-inflammatory cytokines. Some RCTs report improvements in probing pocket depth (PPD), clinical attachment level (CAL), and salivary biomarkers when omega-3s are used adjunctively with scaling and root planing (SRP). However, variability in dosage, source, treatment duration, and outcome measures limits comparability. Few studies assessed SPM levels or reported effect sizes and confidence intervals. Evidence on co-administration with low-dose acetylsalicylic acid (ASA) is inconclusive. Conclusions: Although mechanistically plausible and supported by selected clinical trials, the adjunctive use of omega-3 fatty acids in periodontitis lacks sufficient high-quality, consistent evidence to justify clinical recommendations. Standardized RCTs with robust design, biochemical monitoring, and long-term follow-up are needed. Omega-3s remain a promising component of integrative care but should not yet replace established therapeutic protocols.